Air Quality and Patient Safety in Viet Nam's Healthcare Facilities: Managing Outdoor Pollution and Indoor Exposure

Air Quality and Patient Safety in Viet Nam's Healthcare Facilities: Managing Outdoor Pollution and Indoor Exposure

IMPLEMENTATION INSIGHTS · CLIMATE-RESILIENT HEALTHCARE

Last reviewed: October 27, 2026

A patient arrives at a hospital on a day when outdoor air pollution is high. Inside, the waiting area looks clean, the air conditioning is working, and the temperature feels comfortable. But does that mean the air is suitable for everyone receiving care?

Not necessarily. Fine particles and other outdoor pollutants can enter buildings through ventilation systems, open doors and windows, and unintended air leakage. Indoor activities may introduce additional contaminants, while ventilation and filtration systems influence how pollutants accumulate, circulate, or are removed. A healthcare facility may therefore appear clean and comfortable without having sufficient information about the air that patients, visitors, and healthcare workers are breathing.

This matters because hospitals and clinics serve people who may be particularly susceptible to environmental exposures. Patients with respiratory or cardiovascular conditions, older people, children, and others receiving treatment may have different needs, while healthcare workers often spend extended periods in the same indoor environments.

For healthcare organizations in Viet Nam, managing air quality should be considered part of the broader responsibility to maintain safe and appropriate conditions for care. The challenge is not simply to install sensors or purchase additional filtration equipment. It is to understand which exposures matter, how outdoor and indoor conditions interact, what controls are appropriate for different clinical spaces, and whether those controls are functioning as intended.

Climate change adds another consideration. Changes in temperature, weather patterns, and certain environmental conditions can influence air pollution episodes and the operation of healthcare facilities. However, air pollution and climate change are related but distinct problems, and their effects should not be treated as interchangeable.

For healthcare leaders, the central question is how to translate credible air quality information into practical decisions that protect patients and staff while maintaining the other essential requirements of the care environment.

Why Air Quality Matters for Patient Safety

Air pollution is an established environmental health risk, with consequences extending well beyond respiratory disease.

The World Health Organization's Global Air Quality Guidelines, published in September 2021, provide health-based recommendations for major pollutants, including fine particulate matter (PM2.5), particulate matter with a diameter of 10 micrometers or less (PM10), ozone, nitrogen dioxide, sulfur dioxide, and carbon monoxide. The guidelines reflect extensive evidence linking air pollution exposure to respiratory, cardiovascular, and other adverse health outcomes.

In June 2026, WHO published Health Effects of Air Pollution: Evidence and Implications, a technical brief summarizing established and emerging scientific evidence. The publication describes health effects involving several body systems, including respiratory, cardiovascular, cerebrovascular, reproductive, and metabolic health. It also identifies groups who may face greater risks, including children, pregnant women, older people, individuals living with chronic illnesses, and populations experiencing socioeconomic disadvantage.

These findings are particularly relevant to healthcare facilities because patients receiving care may already be more susceptible to certain exposures than the general population. A patient with asthma, chronic obstructive pulmonary disease, or cardiovascular disease may experience additional health concerns when exposed to relevant pollutants. People recovering from illness or receiving complex treatment may also have particular environmental needs.

However, the relationship between air pollution and health must be interpreted appropriately. Not every symptom occurring during a period of poor air quality is caused by pollution, and environmental exposure information does not replace individualized clinical assessment. Clinical decisions must remain grounded in the patient's condition, available evidence, professional judgment, and applicable clinical guidance.

It is equally important to distinguish population-level evidence from conditions within an individual healthcare facility. The established relationship between air pollution and disease does not automatically demonstrate that a particular hospital's indoor environment is unsafe. Nor does it establish that installing a specific filtration device will improve patient outcomes.

Healthcare organizations need information about their own environments, services, and patient populations before drawing such conclusions.

Understanding How Outdoor Pollution Affects Indoor Air

Outdoor and indoor air quality are connected, but they are not necessarily the same.

Outdoor pollution may originate from transport, industrial activities, construction, fuel combustion, open burning, and other sources. Their relative contributions vary according to location, season, weather, and local activities. Pollutants can enter healthcare buildings through mechanical ventilation systems, open doors and windows, and gaps in the building envelope.

The extent of this movement depends on factors including building design, outdoor pollutant concentrations, ventilation arrangements, filtration performance, pressure relationships, and how spaces are used.

At the same time, healthcare facilities may have their own indoor sources of contamination. Cleaning and disinfection products, laboratory activities, certain medical processes, renovation materials, furnishings, and moisture-related problems can contribute to indoor air quality concerns. Occupancy and routine activities may also influence airborne particle concentrations and the distribution of contaminants.

An indoor air quality problem should therefore not automatically be attributed to outdoor pollution. Equally, closing windows is not necessarily sufficient to maintain suitable indoor conditions. A closed building may reduce the entry of certain outdoor pollutants while still requiring adequate ventilation to manage contaminants generated indoors.

Opening windows may increase outdoor air exchange, but it can also allow additional particulate pollution or other contaminants to enter during periods of poor outdoor air quality.

For example, an outpatient waiting area near a busy road may have different exposure concerns from a patient room located farther from major outdoor pollution sources. A laboratory or specialized treatment room may have additional requirements related to contaminants generated by its activities.

These differences matter when healthcare organizations consider whether to modify ventilation, improve filtration, manage pollution sources, or introduce environmental monitoring. Decisions should reflect the conditions and intended use of each space rather than a general rule about opening windows, increasing ventilation, or operating air conditioning.

Air Pollution and Climate Change: Related but Distinct Challenges

Air pollution and climate change share important connections, particularly through energy production, transport, industry, and other activities that generate emissions.

Some sources of greenhouse gases also release pollutants harmful to human health. Reducing emissions from these sources can therefore provide benefits for both climate mitigation and air quality.

Weather and atmospheric conditions can also influence the formation, movement, and accumulation of pollutants. For example, higher temperatures may contribute to ground-level ozone formation under suitable chemical and atmospheric conditions. Changes in rainfall, wind, atmospheric stability, and other environmental factors can influence the severity or duration of certain pollution episodes.

Climate-related environmental changes may also affect some pollution-generating events, although their significance varies by region.

However, it would be scientifically inappropriate to attribute every episode of poor air quality to climate change. Air pollution is influenced by emissions, atmospheric chemistry, local geography, weather, and other factors. Climate change can interact with these processes, but it does not replace the need to understand actual pollution sources.

For healthcare organizations, the practical relevance of climate resilience lies in recognizing how changing environmental conditions may affect patients, staff, and the ability to maintain suitable indoor environments.

Managing indoor exposure and reducing greenhouse gas emissions are also different objectives. Improving filtration within a hospital may reduce exposure to certain airborne particles without changing the outdoor pollution sources affecting the surrounding community. Likewise, improvements in city-level air quality do not automatically establish that every specialized clinical space meets its environmental requirements.

Both levels of action are important, but they involve different responsibilities and require different forms of evidence.

What International Guidance Tells Us About Healthcare Indoor Environments

International guidance provides a useful foundation for understanding indoor environmental quality in healthcare facilities.

In December 2023, the Pan American Health Organization (PAHO), WHO's Regional Office for the Americas, published Guidance on Indoor Environmental Quality in Health Care Facilities.

The guidance recognizes that healthcare indoor environments are complex. Patients, visitors, healthcare workers, and support personnel may encounter different chemical and microbiological contaminants, while the characteristics of clinical spaces create additional environmental requirements. It considers the influence of airborne contaminants, ventilation, temperature, humidity, and building conditions on indoor environmental quality.

On August 14, 2026, PAHO published a checklist to support implementation of this guidance. The checklist addresses ventilation, filtration, thermal comfort, pressure differentials, and other conditions relevant to healthcare facility management and infection prevention.

Its practical value lies in helping organizations examine existing arrangements, establish a baseline, identify concerns, prioritize improvements, and review progress. The tool may be used for self-assessment or to support structured discussions involving healthcare professionals and technical specialists.

These resources may inform professional learning beyond the Americas, including in Viet Nam. However, they are not Vietnamese regulatory requirements, and using the checklist does not constitute official assessment, accreditation, or certification by PAHO or WHO.

WHO's Roadmap to Improve and Ensure Good Indoor Ventilation in the Context of COVID-19, published in March 2021, also provides relevant principles for understanding ventilation and reducing airborne transmission risks. Although developed during the COVID-19 pandemic, the roadmap illustrates the importance of considering ventilation in relation to occupancy, building characteristics, and the activities performed within a space.

The United States Centers for Disease Control and Prevention (CDC) provides additional guidance on environmental infection control in healthcare facilities, including ventilation, filtration, and specialized airflow arrangements. Its Ventilation in Healthcare Settings Factsheet, updated in January 2026, offers an accessible educational resource on the relationship between ventilation and infection prevention.

These international resources differ in purpose and scope. They can support professional understanding and improvement, but they should not be treated as interchangeable technical standards.

Requirements for a particular healthcare facility or clinical environment must be determined according to its intended functions and the applicable Vietnamese legal, professional, and technical framework.

Air Pollution Control Is Not the Same as Airborne Infection Prevention

Air quality management and infection prevention are closely related, but they address different hazards.

Outdoor air pollution involves physical and chemical pollutants, including particulate matter and gases. Airborne infection transmission involves infectious respiratory particles or other relevant biological agents.

Ventilation and filtration may contribute to managing both types of hazards, but the appropriate assessment methods and protective measures are not identical.

For example, an air quality sensor may provide information about particulate concentrations. It cannot determine whether the measured particles contain infectious microorganisms. A low PM2.5 reading therefore does not establish that airborne infection transmission risks have been adequately controlled.

Similarly, a room may meet selected ventilation requirements while still requiring appropriate clinical infection prevention measures.

Airborne infection prevention can involve patient assessment, appropriate placement, respiratory protection, source control, clinical procedures, and other precautions, depending on the circumstances. Environmental engineering measures support these activities but do not replace them.

This distinction is particularly important when healthcare organizations introduce air quality dashboards or communicate monitoring results.

A general particulate matter reading should not be presented as evidence that an airborne infection isolation room is functioning correctly. Likewise, carbon dioxide measurements should not be interpreted as direct measurements of infectious microorganisms.

Understanding these differences can help prevent well-intended air quality initiatives from creating false reassurance about infection prevention.

Different Healthcare Spaces Need Different Environmental Controls

A healthcare facility contains environments with substantially different requirements.

An outpatient waiting area, administrative office, inpatient ward, operating room, laboratory, and specialized isolation room may differ in occupancy, clinical activities, equipment, and environmental risks.

Some spaces primarily require a suitable general indoor environment. Others need more specific controls because of the procedures performed or the vulnerability of the patients receiving care.

For example, airborne infection isolation rooms may require airflow and pressure arrangements designed to reduce the escape of potentially infectious airborne particles into adjacent areas. Certain protective environments for highly vulnerable patients may require different arrangements intended to limit the entry of airborne contaminants from surrounding spaces.

These requirements can involve pressure relationships, ventilation rates, filtration, airflow patterns, and other technical characteristics.

Negative-pressure and positive-pressure arrangements serve different purposes. Neither should be treated as appropriate for every clinical space.

An intervention that appears beneficial in a general waiting area may be unsuitable for a specialized clinical environment where airflow direction or pressure relationships are important to patient safety.

For this reason, changes to ventilation and filtration in specialized healthcare spaces require qualified technical and clinical review.

Healthcare organizations should begin by understanding what each area is used for and which environmental conditions are necessary to support its intended function. Clinical, infection prevention, engineering, and facilities management personnel may all need to contribute.

The objective is not to apply identical air quality arrangements throughout the building, but to maintain conditions appropriate to the people, activities, and risks associated with each space.

Ventilation, Filtration, and Source Control Must Work Together

Improving indoor air quality usually involves more than one measure.

Source control aims to prevent or reduce pollutants before they enter or accumulate within an indoor environment. Ventilation can help dilute or remove certain contaminants by providing and distributing appropriate outdoor air. Filtration can remove selected airborne particles from air passing through suitable filters.

These approaches have different functions and limitations.

For example, an appropriately selected particle filter may reduce airborne particulate matter but may not effectively remove all gaseous pollutants. Increasing outdoor air supply may improve dilution of indoor-generated contaminants while increasing the entry of outdoor pollution if filtration and other controls are inadequate.

The appropriate balance depends on the pollutants of concern, outdoor conditions, the building system, and the activities occurring inside.

Portable air cleaners may provide additional particulate removal in certain settings when appropriately selected, positioned, operated, and maintained.

However, they should not automatically be treated as replacements for required ventilation or specialized engineering controls. Their effectiveness depends on filtration capability, airflow, placement, maintenance, room characteristics, and the sources of contamination.

Healthcare organizations should also be cautious about products marketed with broad claims of sterilizing or purifying air.

Marketing descriptions do not necessarily establish performance or safety in a particular clinical environment. Some technologies may introduce additional concerns, including the potential generation of unwanted chemical by-products.

Before introducing such equipment, organizations should consider independent evidence, technical specifications, manufacturer instructions, maintenance requirements, and the intended use of the space.

The objective is to select controls that address identified risks rather than assume that adding more air-cleaning equipment will always produce safer care.

Understanding What Air Quality Sensors Can and Cannot Measure

Air quality sensors can help healthcare organizations observe environmental conditions that might otherwise be difficult to recognize.

Depending on their design, devices may measure particulate matter, carbon dioxide, temperature, humidity, or selected gaseous pollutants. These measurements can help identify trends, differences between locations, or conditions requiring further investigation.

However, a sensor reading is useful only when its limitations are understood.

Different devices measure different parameters. A sensor designed to monitor particles does not necessarily provide reliable information about nitrogen dioxide, ozone, volatile organic compounds, or infectious microorganisms.

Measurement performance may be influenced by calibration, sensor aging, temperature, humidity, placement, maintenance, and environmental conditions.

Low-cost sensors can be useful for screening and trend monitoring, but their readings should not automatically be treated as equivalent to measurements obtained using established reference methods.

The location of a sensor also influences its findings.

A device near a hospital entrance may measure different conditions from one located in an internal waiting area. A sensor positioned close to an air outlet, window, or local pollution source may not represent exposure elsewhere in the same room.

When comparing indoor and outdoor measurements, organizations should consider whether the instruments, parameters, locations, and measurement periods are suitable for comparison.

The averaging period also matters. A short-term reading should not automatically be compared with a guideline or regulatory limit defined for a different exposure duration.

Interpreting Air Quality Index and Carbon Dioxide Data

The Air Quality Index (AQI) can provide useful information for public communication, but it is not a direct substitute for pollutant measurements.

Different jurisdictions may use different pollutants, averaging periods, thresholds, and calculation methods. AQI values from different systems should therefore not automatically be treated as directly comparable.

For healthcare organizations, actual pollutant concentrations and relevant measurement details may be more informative than a single summary index, depending on the purpose of the assessment.

Carbon dioxide monitoring also requires careful interpretation.

In occupied indoor spaces, carbon dioxide concentrations may provide information relevant to the balance between occupancy and outdoor air ventilation under certain assumptions.

However, carbon dioxide is not a comprehensive indicator of indoor air quality.

A low reading does not establish that particulate pollution, chemical contaminants, or airborne infection risks are adequately controlled. An elevated reading may indicate a need to examine occupancy or ventilation conditions, but it does not independently establish the presence of a particular pathogen or predict an individual's infection risk.

Carbon dioxide measurements may also be influenced by sensor location, outdoor concentrations, occupancy patterns, and the characteristics of the ventilation system.

In addition, filtration systems may reduce certain airborne particles without producing a corresponding reduction in carbon dioxide concentration.

For healthcare organizations, the appropriate approach is to interpret carbon dioxide information alongside other relevant evidence rather than use a single threshold as proof that a space is safe or unsafe.

Turning Air Quality Data Into Practical Decisions

The value of environmental monitoring depends on how healthcare organizations use the information.

A dashboard displaying particulate concentrations may improve awareness, but it does not automatically improve the conditions experienced by patients or healthcare workers.

The organization needs to understand why information is being collected, which decisions it may support, and who is responsible for reviewing the findings.

Consider an outpatient waiting area where particulate concentrations repeatedly increase during certain periods of the day.

The observation may warrant further investigation of outdoor pollution, occupancy, door-opening patterns, nearby construction activities, ventilation, filtration, or other possible factors. It should not automatically lead to the conclusion that a particular air-conditioning system has failed.

Similarly, lower indoor particulate concentrations than those measured outdoors may suggest that the building is reducing some outdoor pollution exposure. However, the comparison does not demonstrate that every relevant indoor environmental requirement has been met.

A useful monitoring approach connects measurements with investigation, appropriate corrective action, and follow-up.

This may involve reviewing ventilation system performance, filter condition, maintenance records, building activities, operating procedures, or the suitability of existing environmental controls.

Responsibility for interpreting technical findings should remain with appropriately qualified personnel. Clinical and infection prevention teams can contribute by explaining how findings may relate to particular patient populations or clinical activities. Healthcare managers can support the process by ensuring that concerns are reviewed and agreed actions are implemented.

The purpose of monitoring is not simply to obtain favorable readings. It is to provide information that helps healthcare organizations maintain appropriate conditions for care.

Why Waiting Areas and General Clinical Spaces Deserve Attention

Specialized healthcare environments such as operating rooms and intensive care units receive considerable attention in research on indoor air quality and environmental control. This is understandable because of the activities performed and the potential consequences of inadequate environmental conditions.

However, general clinical spaces also deserve consideration.

Patients may spend extended periods in outpatient waiting areas, registration areas, corridors, and other shared environments. Some of these spaces have variable occupancy, frequent movement through entrances, and greater interaction with outdoor conditions.

A review published in Discover Environment on September 1, 2026, examined global evidence and research gaps concerning indoor air quality in healthcare facilities.

The review, conducted by Sandya Menon, Siew Tung Wong, and Shew Fung Wong, synthesized 215 peer-reviewed publications from 2015–2025, including 189 primary studies and 26 review papers.

The analysis found that operating rooms and intensive care units were frequently investigated, representing approximately 44% and 35% of the primary studies, respectively, while fewer than 2% investigated patient waiting areas.

These figures describe the research settings represented in the literature. They do not mean that the categories are mutually exclusive, since some studies examined more than one clinical environment.

The review also identified geographical imbalances, limited investigation of certain chemical pollutants, and inconsistencies in monitoring and reporting practices.

These findings highlight gaps in the available evidence rather than establish that waiting areas are more hazardous than specialized clinical spaces.

The authors also discussed the importance of considering local climatic and building conditions, particularly in tropical healthcare settings. However, the study was a scoping review intended to map available research, not a direct assessment of air quality or patient outcomes in Vietnamese hospitals.

For healthcare organizations in Viet Nam, the practical implication is that environmental assessment should reflect actual use and exposure concerns rather than focus exclusively on locations where technical monitoring is already well established.

An outpatient clinic near a busy road, for example, may experience different environmental challenges from an inpatient ward in a more protected part of a building.

The appropriate response depends on local conditions and should be informed by relevant evidence rather than assumptions about which spaces are always safe.

What Experience From Viet Nam Tells Us

Viet Nam has already gained practical experience with air quality monitoring in healthcare facilities.

On November 7, 2025, WHO published Viet Nam: Hospitals Adopt Air Quality Initiatives for Safer Health Care and Healthier Communities.

The report described how the Ministry of Health, with support from WHO and partners, introduced air quality sensors at three hospitals as part of a wider effort to advance climate-resilient and environmentally sustainable healthcare facilities.

The participating facilities were Yen Thanh General Hospital in Nghe An Province, Cu Lao Minh Area General Hospital in Vinh Long Province, formerly part of Ben Tre Province, and Bac Ha District Hospital in Lao Cai Province.

At Yen Thanh General Hospital, monitoring points included the waste treatment area, hospital entrance, and outpatient department. These locations illustrate how air quality monitoring can be introduced in areas with different environmental characteristics and operational functions.

The sensors provide real-time information that can help hospital personnel observe trends, compare selected indoor and outdoor conditions, and identify issues requiring further attention.

This is a useful implementation experience because it shows that environmental monitoring has already been incorporated into practical healthcare improvement activities in Viet Nam.

It also demonstrates the potential value of making environmental information available to healthcare managers, technical personnel, and other relevant staff.

However, the pilot should not be interpreted as evidence that installing sensors independently reduced pollution exposure, healthcare-associated infections, or adverse patient outcomes.

Monitoring provides information. Demonstrating reduced exposure or improved health outcomes requires appropriate interventions and evidence that those interventions achieved their intended effects.

The pilot also does not establish that all Vietnamese hospitals have comparable monitoring capabilities or that identical monitoring arrangements would be suitable for every facility.

Its value for professional learning lies in the questions it raises: which spaces should be monitored, which parameters are relevant, who reviews the findings, and what happens when an unexpected pattern is identified?

These are practical questions for healthcare organizations interested in connecting environmental information with patient safety and quality improvement.

Recent Air Quality Policy Developments in Viet Nam

Air pollution remains a significant environmental and public health concern in Viet Nam.

On September 28, 2026, WHO and the United Nations Development Programme (UNDP) published Air Pollution in Viet Nam: Turning Policies Into Action.

The commentary emphasized the importance of stronger monitoring, integration of environmental and health information, coordinated policies, risk communication, and practical implementation.

It also highlighted the challenges associated with periods of poor air quality in Ha Noi and the need to protect vulnerable populations.

At the national level, Prime Minister's Decision No. 2530/QD-TTg, dated November 19, 2025, approved the National Action Plan on Overcoming Pollution and Managing Ambient Air Quality for 2026–2030, with a Vision to 2045.

The plan addresses air pollution through measures involving monitoring, emissions control, coordination, and other actions intended to improve ambient air quality.

On September 29, 2026, WHO reported on Viet Nam's Second National Conference on Combating Air Pollution and Improving Air Quality, jointly organized by the Ministry of Agriculture and Environment, the Ministry of Health, UNDP, and WHO.

The conference brought together government representatives, researchers, technical specialists, and development partners to discuss how national air quality commitments could be translated into practical action.

Discussions addressed governance, financing, environmental monitoring, emissions control, technology, and coordination across sectors.

These developments provide important policy context for healthcare organizations.

However, national ambient air quality policies should not be interpreted as establishing identical indoor air quality requirements for every hospital, clinic, or specialized clinical space.

Environmental policy and healthcare facility management operate at related but different levels.

For healthcare organizations, the practical question is how reliable outdoor air quality information, relevant technical guidance, and local environmental conditions can inform decisions concerning their own facilities and the people receiving or providing care.

Applying International Guidance Within Viet Nam's Legal Framework

Air quality management in Vietnamese healthcare facilities involves several related legal and technical frameworks.

These include environmental protection, ambient air quality, indoor environmental conditions, building ventilation, occupational health, and infection prevention and control.

The Law on Environmental Protection, No. 72/2020/QH14, as amended, provides the broader legal foundation for environmental protection and pollution management.

Ministry of Natural Resources and Environment Circular No. 01/2023/TT-BTNMT, dated March 13, 2023, issued national technical regulations concerning environmental quality, including QCVN 05:2023/BTNMT.

The Circular took effect on September 12, 2023.

QCVN 05:2023/BTNMT establishes limits for specified pollutants in ambient air and provides a framework for monitoring and assessing ambient air quality.

Importantly, its scope expressly excludes indoor air.

Its limits should therefore not be presented as a comprehensive set of technical requirements governing air quality inside hospitals or clinics.

WHO's 2021 Global Air Quality Guidelines also provide health-based recommendations for major pollutants. These guidelines are important international references but do not automatically become binding Vietnamese regulatory limits or replace technical requirements for specialized clinical environments.

Vietnamese Standards for Indoor Air and Ventilation

Viet Nam has national standards relevant to indoor air quality and ventilation.

TCVN 13521:2022, Residential and Public Buildings — Indoor Air Quality Parameters, addresses indoor air quality parameters in residential and public buildings.

The categories of public buildings identified in its scope include hospitals, health stations, clinics, maternity facilities, and other healthcare-related buildings.

The standard specifies indoor air quality parameters and associated limits within its defined scope, including conditions involving buildings operated with closed windows during cold periods or air conditioning during hot periods.

It provides a technical reference for assessing indoor environments and informing building envelope and ventilation or air-conditioning design within the circumstances covered by the standard.

TCVN 5687:2024, Ventilation and Air Conditioning — Design Requirements, provides technical requirements for designing and installing ventilation and air-conditioning systems within its applicable scope, particularly for new construction and renovation.

The standard replaced TCVN 5687:2010 and remains listed as effective.

These standards address related but different technical questions. TCVN 13521:2022 concerns indoor air quality parameters, while TCVN 5687:2024 concerns ventilation and air-conditioning design.

Neither should be treated as interchangeable with QCVN 05:2023/BTNMT, which addresses ambient air.

Their application also requires appropriate legal interpretation.

Vietnamese national standards are generally voluntary unless their requirements become applicable through relevant technical regulations, legal instruments, contracts, or other recognized mechanisms.

Where another applicable document references a particular edition of a technical standard, that reference should be interpreted according to its terms. The publication of a newer standard does not automatically resolve every question concerning an earlier dated reference.

Healthcare organizations should therefore determine which provisions apply to their facilities and projects rather than assume that every published standard is automatically mandatory in full.

General indoor air quality and ventilation standards should also not be treated as sufficient for every specialized medical environment.

Operating rooms, airborne infection isolation rooms, protective environments, and other specialized clinical spaces may require additional ventilation, filtration, airflow, or pressure controls according to their intended functions and applicable professional and technical requirements.

Infection Prevention and Professional Responsibilities

The Law on Medical Examination and Treatment, No. 15/2023/QH15, effective January 1, 2024, provides another relevant legal foundation.

Article 74 addresses infection prevention and control in healthcare facilities, including responsibilities concerning preventive measures, appropriate facilities, and safe conditions for healthcare activities.

Ministry of Health Circular No. 16/2018/TT-BYT, dated July 20, 2018, provides requirements concerning infection prevention and control in healthcare facilities.

At the time of this review, the Circular remained recorded as effective. In September 2026, the Ministry of Health released a proposed replacement for public consultation.

That draft should not be treated as having superseded the existing Circular unless a replacement is formally issued and becomes effective.

Healthcare organizations should apply the requirements currently in force, alongside relevant technical standards and professional guidance.

International PAHO, WHO, and CDC resources may support professional learning and improvement, but they do not automatically establish additional licensing, accreditation, or certification obligations in Viet Nam.

For Climate & Health Vietnam, this distinction is important. Explaining credible international evidence is different from determining whether a particular healthcare facility meets all applicable technical or legal requirements.

Making Air Quality Part of Routine Healthcare Governance

Indoor air quality can become difficult to manage when responsibilities are distributed across departments without sufficient coordination.

Facilities personnel may operate ventilation and air-conditioning systems. Engineering teams may oversee technical maintenance. Infection prevention professionals may identify requirements related to airborne infection risks, while clinical personnel may recognize concerns affecting particular patients.

Housekeeping, procurement, construction management, and external contractors can also influence indoor environmental conditions.

These responsibilities are interconnected.

For example, a particulate pollution concern in a patient waiting area may involve outdoor conditions, air intake locations, filtration performance, building use, or several factors operating together.

A recurring complaint about indoor air may require investigation of cleaning activities, moisture, ventilation, maintenance, or other potential sources rather than immediate replacement of an air-conditioning unit.

Healthcare organizations can therefore benefit from clear arrangements for identifying concerns, reviewing available information, obtaining technical and clinical input, and following up on corrective actions.

The approach should remain proportionate to the facility's size and clinical services.

A small outpatient clinic may need relatively simple management arrangements, while a large hospital with specialized clinical environments may require more complex coordination.

The objective is not necessarily to establish a separate air quality department or additional reporting system.

Where existing quality, infection prevention, occupational safety, and facilities management structures already provide suitable arrangements, they can support air quality improvement.

What matters is that responsibilities are understood, information is interpreted appropriately, and identified concerns lead to suitable action.

Measuring Improvement Without Overstating Results

Healthcare organizations may use different forms of evidence to understand indoor air quality.

These can include measurements of selected pollutants, ventilation system performance, maintenance records, temperature and humidity information, and observations about how spaces are used.

Each measure describes only part of the environment.

A PM2.5 sensor provides information about fine particulate concentrations within the limitations of the device. It does not establish that every gaseous contaminant is controlled.

A carbon dioxide measurement may support an assessment of ventilation under appropriate assumptions but does not independently demonstrate infection safety or overall indoor environmental quality.

Likewise, a maintenance record showing that filters were replaced does not necessarily demonstrate that the complete ventilation system is functioning as intended.

Monitoring should therefore be designed around clearly defined questions.

For example, particulate trends may help identify periods requiring further investigation. Ventilation or pressure measurements may be relevant to selected engineered environments, while professional observation may reveal problems not captured by routine sensor data.

The interpretation should reflect the clinical setting, measurement methods, and applicable technical requirements.

Organizations should also avoid assuming that a reduction in one pollutant automatically demonstrates better patient outcomes.

Air quality is an important environmental determinant of health, but clinical outcomes are influenced by many factors.

Demonstrating that a particular intervention has improved patient outcomes would require suitable clinical data and an appropriate evaluation approach.

For many healthcare organizations, more limited monitoring objectives may be realistic and useful.

These may include determining whether selected pollutant concentrations have changed, whether relevant environmental control systems are functioning as intended, and whether identified problems have been addressed.

The purpose is to support informed decisions and continuous improvement rather than produce favorable environmental scores without sufficient evidence.

Balancing Indoor Air Protection With Energy and Environmental Sustainability

Indoor air quality management also has implications for energy consumption and environmental sustainability.

Mechanical ventilation, cooling, filtration, and other environmental control systems can require substantial energy, depending on the building and its clinical functions.

Increasing outdoor airflow or filtration capacity may affect energy use, equipment performance, maintenance requirements, and operating costs.

Conversely, reducing ventilation or changing environmental control arrangements primarily to save energy can create risks if the changes compromise conditions required for safe care.

The appropriate balance depends on the activities occurring in the space and the environmental controls needed to support those activities.

Changes to ventilation in an operating room or specialized isolation room, for example, should not be based solely on an expected reduction in electricity consumption.

Likewise, installing additional filtration equipment should not automatically be described as environmentally sustainable without considering its energy consumption, maintenance, replacement materials, and demonstrated benefits.

In some circumstances, improved operating controls, suitable equipment selection, effective maintenance, and better understanding of building performance may help organizations improve indoor environmental conditions while using resources more efficiently.

However, these benefits should be established through appropriate evidence rather than assumed.

The objective is to pursue environmental sustainability while maintaining the conditions necessary for safe, appropriate, and reliable healthcare.

This is consistent with WHO's broader approach to climate-resilient and environmentally sustainable healthcare facilities.

What Climate & Health Vietnam Can Contribute

For Climate & Health Vietnam (CHVN), air quality and patient safety represent a relevant area for evidence synthesis, professional learning, and implementation-oriented collaboration.

The subject connects climate-resilient healthcare with environmental health, infection prevention, patient safety, healthcare quality, and facility governance.

CHVN can contribute by explaining the relationship between outdoor pollution, indoor exposure, ventilation, filtration, environmental monitoring, and the different requirements of healthcare spaces.

It can also help healthcare professionals understand what air quality measurements can establish, where their limitations lie, and how such information may inform organizational improvement.

An important area of professional learning is the distinction between general indoor air quality and the environmental controls required for specialized clinical functions.

This distinction can help prevent the inappropriate application of broad environmental recommendations to settings where additional infection prevention or technical requirements are necessary.

CHVN may facilitate professional discussions involving healthcare managers, clinical personnel, infection prevention professionals, environmental health specialists, facilities teams, engineers, researchers, and other relevant stakeholders.

Potential contributions include credible evidence summaries, educational resources, implementation discussions, and collaboration on identifying practical knowledge gaps.

Such activities should remain within CHVN's actual expertise, institutional capacity, and applicable legal and professional boundaries.

CHVN should not present its educational materials as official WHO or PAHO assessments or imply authority to certify indoor air quality, validate ventilation systems, determine engineering compliance, or establish mandatory healthcare environmental standards.

Where specialized measurements, ventilation design, filtration assessment, pressure testing, occupational exposure evaluation, or legal compliance verification are required, appropriately qualified and authorized professionals or organizations should be involved.

CHVN's role is to make credible evidence more accessible, explain its relevance to healthcare in Viet Nam, and encourage informed professional learning and collaboration.

This is consistent with an approach to climate-resilient healthcare in which healthcare quality, patient safety, governance, and practical implementation remain central.

From Outdoor Pollution to Safer Indoor Care

Air quality is often discussed as an environmental problem outside healthcare facilities, but the conditions inside hospitals and clinics also deserve attention.

Outdoor pollution can enter buildings, while indoor activities and building conditions may introduce additional contaminants. Ventilation and filtration can help manage selected risks, but their effectiveness depends on appropriate design, operation, maintenance, and the intended function of the space.

For healthcare leaders, the challenge is to understand these relationships without relying on overly simple indicators or solutions.

A favorable particulate reading does not demonstrate that airborne infection risks have been controlled. A well-maintained ventilation system in one area does not establish that the environmental needs of every clinical space are being met.

For healthcare organizations in Viet Nam, improvement can begin by identifying the areas where air quality concerns may be relevant, understanding the pollutants or risks involved, reviewing existing controls, and determining what additional information is needed.

Some facilities may benefit from better monitoring. Others may need to investigate ventilation or filtration performance, improve maintenance, address indoor pollution sources, or clarify responsibilities between clinical and technical teams.

The appropriate response will depend on the facility, the patients it serves, the activities performed, and the environmental conditions it faces.

Not every improvement requires expensive new equipment. Clear responsibilities, reliable maintenance, informed interpretation of environmental data, and appropriate corrective action can also support safer indoor conditions.

For healthcare leaders, the objective should not be to demonstrate that the air is clean simply because a monitoring device displays favorable numbers.

It should be to understand whether the indoor environment is appropriate for its intended clinical use and whether the organization can identify and address conditions that may affect patients, staff, and visitors.

Protecting patients from air pollution requires more than monitoring outdoor conditions or installing indoor air-cleaning equipment. It requires understanding exposure, maintaining appropriate environmental controls, and connecting credible air quality information with practical decisions that support safe care.

Selected References and Policy Context

International Guidance and Evidence

World Health Organization. WHO Global Air Quality Guidelines: Particulate Matter (PM2.5 and PM10), Ozone, Nitrogen Dioxide, Sulfur Dioxide and Carbon Monoxide. September 22, 2021.

World Health Organization. Roadmap to Improve and Ensure Good Indoor Ventilation in the Context of COVID-19. March 1, 2021.

Pan American Health Organization. Guidance on Indoor Environmental Quality in Health Care Facilities. December 1, 2023.

World Health Organization. Air Pollution: Personal Interventions and Risk Communication. October 4, 2024.

World Health Organization. Health Effects of Air Pollution: Evidence and Implications. Technical brief. June 21, 2026.

Pan American Health Organization. Checklist for the Application of Pan American Health Organization Guidance on Indoor Environmental Quality in Healthcare Facilities. August 14, 2026.

United States Centers for Disease Control and Prevention. Guidelines for Environmental Infection Control in Health-Care Facilities, including recommendations relevant to ventilation, filtration, and specialized healthcare environments.

United States Centers for Disease Control and Prevention. Ventilation in Healthcare Settings Factsheet. Updated January 2026.

World Health Organization. Operational Framework for Building Climate Resilient and Low Carbon Health Systems. November 9, 2023.

Menon, S., Wong, S. T., and Wong, S. F. Global Evidence and Research Gaps on Indoor Air Quality in Healthcare Facilities. Discover Environment. Volume 4, Article 472. September 1, 2026.

Selected Evidence and Policy Developments From Viet Nam

World Health Organization Viet Nam. Viet Nam: Hospitals Adopt Air Quality Initiatives for Safer Health Care and Healthier Communities. November 7, 2025.

World Health Organization Viet Nam and United Nations Development Programme Viet Nam. Air Pollution in Viet Nam: Turning Policies Into Action. September 28, 2026.

World Health Organization Viet Nam. Viet Nam's Second National Air Pollution Conference to Focus on Turning Policy Commitments Into Clearer Air. September 29, 2026.

Viet Nam Legal, Policy, and Technical Context

National Assembly. Law on Medical Examination and Treatment No. 15/2023/QH15, effective January 1, 2024, particularly Article 74 concerning infection prevention and control.

National Assembly. Law on Environmental Protection No. 72/2020/QH14, effective January 1, 2022, as amended.

Ministry of Natural Resources and Environment. Circular No. 01/2023/TT-BTNMT, dated March 13, 2023, issuing national technical regulations concerning ambient environmental quality, effective September 12, 2023.

Ministry of Natural Resources and Environment. QCVN 05:2023/BTNMT — National Technical Regulation on Air Quality, applicable to ambient air quality and expressly excluding indoor air.

Viet Nam. TCVN 13521:2022 — Residential and Public Buildings: Indoor Air Quality Parameters.

Viet Nam. TCVN 5687:2024 — Ventilation and Air Conditioning: Design Requirements, replacing TCVN 5687:2010.

Ministry of Health. Circular No. 16/2018/TT-BYT, dated July 20, 2018, concerning infection prevention and control in healthcare facilities, as applicable at the time of review.

Prime Minister of Viet Nam. Decision No. 2530/QD-TTg, dated November 19, 2025, approving the National Action Plan on Overcoming Pollution and Managing Ambient Air Quality for 2026–2030, with a Vision to 2045.

Professional scope: This article is intended for professional education, evidence synthesis, and knowledge sharing. It does not constitute individualized clinical advice, a facility-specific indoor air quality assessment, ventilation or filtration design instructions, environmental or occupational exposure certification, engineering advice, legal advice, a regulatory compliance determination, an official WHO or PAHO assessment, or accreditation or certification criteria. References to air quality monitoring, ventilation, filtration, clinical environments, and technical standards are provided for general professional understanding and should not replace the requirements applicable to a particular healthcare facility or clinical activity. References to WHO, PAHO, CDC, and other organizations do not imply endorsement of Climate & Health Vietnam or its activities. Healthcare organizations should apply current Vietnamese laws, applicable technical regulations and standards, relevant professional guidance, and qualified clinical, infection prevention, environmental health, occupational safety, engineering, facilities management, and organizational judgment when assessing or improving indoor air quality.